NPI | 1346903077 |
---|---|
Former Name | SANDRA WILBANKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 122530) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 122530) |
1041C0700X Social Worker, Clinical (Licence: CA 102307) | |
Enumeration Date | 2021-10-19 |
Last Update Date | 2024-07-19 |